Biases on the administered parenteral doses of an experimental drug during phase I clinical trials

Introduction: The pharmaceutical aspects of drug administration in clinical trials receive poor consideration compared with the important attention devoted to the analytical and mathematical aspects of biological sample exploitation. During PK calculations, many researchers merely use for dose the nominal amount declared, overlooking the noticeable biases that may result in the assessment of PK parameters. The aim of this work was to evaluate the biases related to doses injected of a biosimilar drug in 2 Phase I clinical trials. Patients (or Materials) and Methods: In trial A, 12 healthy volunteers received different doses of a biosimilar of interferon beta-1a by either subcutaneous (SC) or intravenous (IV) injection. The doses were prepared by partially emptying 0.5-mL syringes supplied by the manufacturer (drop count procedure). In trial B, 12 healthy volunteers received 3 different formulations of the drug by IV injection (biosimilar without albumin [HSA], biosimilar with HSA and original brand [Rebif®]) and 2 different formulations as multiple SC injections (biosimilar HSA-free and original brand). In both trials, the actual dose administered was calculated as: D = C·V - losses. The product titer C was assessed by ELISA. The volume administered IV was assessed by weighting. Losses were evaluated by in vitro experiments. Finally, the binding of 125I-interferon to HSA was evaluated by counting the free and HSA complexed molecule fractions separated by gel filtration. Results: Interferon was not significantly adsorbed onto the lines used for its IV administration. In trial A, the titer was very close to the one declared (96 ± 7%). In trial B, it differed significantly (156 ± 10% for biosimilar with/without HSA and 123 ± 5% for original formulation). In trial A, the dose actually administered showed a large variability. The real injected volume could be biased up to 75% compared with the theoretical volume (for the lower dose administered [ie, 0.03 mL]). This was mainly attributed to a partial re-aspiration of the drug solution before withdrawing the syringe needle. A strict procedure was therefore applied in trial B to avoid these inaccuracies. Finally, in trial B, 125I-Interferon beta-1a binding to HSA appeared time dependent and slow, reaching 50% after 16-hour incubation, which is close to steady state reported for the comparator Rebif®. Conclusion: These practical examples (especially biases on actual titer and volume injected) illustrate that actual dose assessment deserves attention to ensure accuracy for estimates of clearance and distribution volume in the scientific literature and for registration purposes, especially for bioequivalence studies.

The northern provinces of Sweden and Norway with part I of Russia

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

The northern provinces of Sweden and Norway with part I, of Russia / published under the superintendence of the Society for the Diffusion of Useful Knowledge.

[N. 1:4400000].

Moscovey in Europe. From latest observations. Humbly inscrib'd to Abel Ketelbey of the Inner Temple Esqz. By I. Senex.

[N. 1:4250000].

Beyond child's play : wealth, status, and the death of children in the MH-LH I periods of the Argolid, Greece

This study explores the mortuary remains of children from the MH-LH I periods of the Argolid, Greece. This examination concentrates on how the child in death acted as a tool for wealth and status display. Here, children are understood to have perpetuated, maintained, and reinforced status distinctions between families in their community. The analysis of one hundred child burials that date to these periods illustrates how the burials of children were important opportunities used by the families of children to display wealth and status. Thus, children can be viewed as important factors in the reorganization of social structure in the transition from the Middle to Late Helladic.

Interpretation of the anisotropy of M MO radiation in slow I on Au collisions

A comparison between experimental and calculated spectral shape and energy dependence of the M MO x-ray anisotropy in heavy-ion collisions of I on Au is presented. The calculation is performed within the kinematic-dipole model of anisotropy using MO x-rays determined from SCF relativistic correlation diagrams.

A survey of auditory training procedures at C.I.D.

This paper examines the auditory training procedures used at Central Institute for the Deaf.